Division of Obstetrics and Gynecology, Department of Maternal, Neonatal and Infant Medicine, Nuovo Ospedale degli Infermi, Biella, Italy.
Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy.
Am J Perinatol. 2019 Jul;36(S 02):S91-S98. doi: 10.1055/s-0039-1692130. Epub 2019 Jun 25.
To systematically evaluate pregnancy and labor course, obstetrical complications, and maternal and neonatal outcomes in women with endometriosis, stratifying according to the specific location of the disease.
We retrospectively analyzed our prospectively maintained obstetrical database from January 2011 to August 2014 to identify all women with a previous histological diagnosis of endometriosis who delivered at our institution (cases). We divided the cases according to the specific location of the disease (deep infiltrating endometriosis, ovarian endometriosis, and peritoneal endometriosis). As controls, we identified all unaffected women who delivered in the year 2013. To avoid the confounding effect of parity, we limited our analysis to nulliparous women.
A total of 118 nulliparous women with endometriosis and 1,690 nulliparous controls were identified. Women with endometriosis were significantly older, had a lower body mass index, and had a higher incidence of assisted reproductive technology. The duration of pregnancy was significantly shorter among women with endometriosis. A higher incidence of placenta previa (3.4 vs. 0.5%; = 0.006), hypertension (11 vs. 5.9%; = 0.04), cesarean section (41.5 vs. 24.2%; < 0.0001), and vacuum delivery (10.1 vs. 2.9%; = 0.006) was found in women with endometriosis. Neonatal outcomes were similar between groups. The incidence of placenta previa in patients with deep endometriosis was 11.7 versus 0.5% among controls ( < 0.0001), whereas in women with ovarian and peritoneal endometriosis, it was similar to the controls.
Women with endometriosis have a higher incidence of vacuum delivery, cesarean section, and placenta previa compared with unaffected women. The higher risk of placenta previa is attributable exclusively to women with deep endometriosis. Neonatal outcomes are unaffected by the presence of the disease.
系统评估根据疾病的具体部位分层的子宫内膜异位症患者的妊娠和分娩过程、产科并发症以及母婴结局。
我们回顾性分析了 2011 年 1 月至 2014 年 8 月期间在我院分娩且有子宫内膜异位症既往组织学诊断的所有妇女（病例）的前瞻性维持产科数据库。我们根据疾病的具体部位（深部浸润性子宫内膜异位症、卵巢子宫内膜异位症和腹膜子宫内膜异位症）将病例进行分类。作为对照，我们在 2013 年确定了所有未受影响的分娩妇女。为避免产次的混杂影响，我们将分析仅限于初产妇。
共确定了 118 例初产妇子宫内膜异位症患者和 1690 例初产妇对照。子宫内膜异位症患者年龄较大，体重指数较低，辅助生殖技术的发生率较高。子宫内膜异位症患者的妊娠持续时间明显缩短。子宫内膜异位症患者胎盘前置的发生率较高（3.4%比 0.5%； = 0.006）、高血压（11%比 5.9%； = 0.04）、剖宫产（41.5%比 24.2%； < 0.0001）和真空分娩（10.1%比 2.9%； = 0.006）的发生率也较高。两组新生儿结局相似。深部子宫内膜异位症患者胎盘前置的发生率为 11.7%，而对照组为 0.5%（ < 0.0001），而卵巢和腹膜子宫内膜异位症患者的发生率与对照组相似。
与未受影响的妇女相比，子宫内膜异位症患者真空分娩、剖宫产和胎盘前置的发生率较高。胎盘前置的高风险仅归因于深部子宫内膜异位症患者。疾病的存在不影响新生儿结局。
